STUDENTS WITH EARLY PSYCHOSIS

STUDENTS WITH EARLY PSYCHOSIS:

(Identification and management): 3.

Dr Lim Wee Kiak asked the Minister for Education if he will provide an update on the measures that our education institutions have in place to identify and manage students with early psychosis who may pose a danger to fellow students or staff.

The Minister of State for Education (RAdm (NS) Lui Tuck Yew) (for the Minister for Education): Mr Speaker, Sir, psychosis is a mental health condition that can distort a person's perception of reality. A person who has this illness may show other symptoms such as hallucinations, disordered thinking or abnormal behaviour. It is a treatable condition and full recovery is possible, especially when

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it is detected early and given the appropriate medical treatment.

Our schools have in place a tiered referral system, under which students who exhibit signs of problems in their psychological or mental well-being are referred for help.

At the first tier is the teacher. If the teacher detects anything amiss, she will provide the child with the necessary support, including referring him or her for further intervention by the trained teacher counsellors (TCs), part-time or full-time school counsellors (PTSCs or FTSCs), who form the second tier of support.

Complicated cases are referred to the third tier of support, which usually involves intervention from mental health professionals from external agencies, such as the Child Guidance Clinic in the IMH.

Follow-up support is also a crucial component of the treatment plan to help individuals with psychosis recover and reintegrate back into normal daily life. When these students return to school following treatment, the school personnel work closely with the parents to provide the appropriate socio-emotional support. Teachers also take the cue and advice from the psychiatrist regarding the student's readiness to resume the various daily activities in school, as well as monitor his/her post-hospitalisation or post-treatment behaviour.

To better equip our school personnel to support students with psychotic disorders, training courses have been organised for the full-time school counsellors in the secondary schools and junior colleges/centralised institute this year. The training includes signs and symptoms of psychosis and ways to engage the student, his or her parents and the other teachers. The different sources of support provided by the Institute of Mental Health under the Early Psychosis Intervention Programme (EPIP) and ways

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to re-integrate the student back to school are also covered in the course.

Our ITEs, polytechnics and universities have also set up similar systems for detecting and supporting troubled students. These include providing training on the signs and symptoms of psychosis, and how to support and refer such students to the appropriate helping services. Some have also established close collaboration with the Institute of Mental Health through the EPIP.

Dr Lim Wee Kiak (Sembawang): Mr Speaker, Sir, I thank the MOS for providing a comprehensive answer to the Question. It was reported in USA Today on May Day itself that up to 14.9% of the United States' college students have clinical signs that satisfy clinical depression. And amongst these, 38% are taking medication and 25% are in other forms of therapy for depression. I would like to ask the MOS: is the Ministry of Education actively collecting data and monitoring the trends of psychiatric disorders amongst students in our schools and the varsity? And with reference to the unfortunate incident in Virginia Tech in Maryland, what more can be done to detect these students and treat them early?

RAdm [NS] Lui Tuck Yew: I think the data that we have shows that in 2006, only 31 out of a total of 7,155 cases of schizophrenia, which is the most common form of psychosis, were diagnosed for patients under 18 years by the Child Guidance Clinic of the Institute of Mental Health. That is the data that we have right now. With regard to what happened in the University of Virginia, as I have mentioned in the reply, our polytechnics, universities and institutions of higher learning actually have a system in place where there are people who are on the lookout for such developments or such symptoms arising. The difference of course is that we hardly have instances

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where people have access to weapons which I think, in part, accounted for the tragedy that happened in the United States recently.

Mdm Halimah Yacob (Jurong): I would like to ask the MOS whether there are any programmes in place in schools, not only to train the counsellors and the teachers, but also to raise awareness amongst students about the challenges and problems that students with psychotic problems face, because the feedback I get is that such problems do carry a stigma and some of these in the schools can result in the student being isolated, marginalised or picked upon, and that does not help in their rehabilitation. So I think a much broader-based awareness problem is necessary to be put in place for teachers and students as well. Are there any plans to do that or are there already programmes of this nature in schools?

RAdm [NS] Lui Tuck Yew: I think the areas that we are actually paying greater attention to right now will be dyslexia, autism as well as, for example, other behavioural problems which are more common based on the incident rates compared to what we know of psychosis. The full-time school counsellors are still an early element in terms of their introduction into the schools and certainly, we are working towards making the full use of this capability and resource in the schools to further educate our school children in all these different signs and symptoms that they should look out for, as well as to also help them understand how to better work with some of these children who may display such signs and symptoms over time.

Dr Fatimah Lateef (Marine Parade): Sir, I would like to find out whether there are such programmes or whether staff in the preschool arena are being trained to identify such cases because we know that

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some of these cases actually surface very early on and the earlier the intervention is done, the better it is because the preschool area is one of the areas where these programmes are lacking.

RAdm [NS] Lui Tuck Yew: Specifically on psychosis, international studies from countries like Australia and US indicate that the onset of psychosis occurs most commonly in late teenage and young adult years, from 16 years and onwards. At least, in reference to this particular area, I do not think we will want to be introducing any specific programmes into the preschool level at this point in time.